Individual
GEORGE MACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3868 MISSION DR N, LAKE HAVASU CITY, AZ 86406-4435
(928) 453-8650
Mailing address
3868 MISSION DR N, LAKE HAVASU CITY, AZ 86406-4435
(928) 453-8650
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1041
AZ
363AM0700X
Medical Physician Assistant
1041
AZ
Other
Enumeration date
05/07/2015
Last updated
05/07/2015
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